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Alzheimer's Disease

Memory loss that disrupts daily life may be a symptom of Alzheimer's or another type of dementia. Alzheimer's is a progressive brain disease that causes a slow decline in memory, thinking and reasoning skills in approximately 5.4 million Americans. Most people with Alzheimer’s are 65 years old and older. However, about five percent of people with Alzheimer’s have early onset Alzheimer’s and are in their 40s or 50s.

People with Alzheimer’s have trouble communicating, learning, thinking and reasoning. Over time, these problems become severe enough to impact their work, social activities and family life. Alzheimer’s destroys brain cells and over time, the disease gets worse and it is fatal.

Alzheimer’s disease is the sixth leading cause of death in the United States and the only cause of death among the top 10 in the U.S. that cannot be prevented, cured or slowed. Early diagnosis provides the best opportunities for treatment, support and future planning.

Alzheimer’s is the most common form of dementia, a general term for memory loss and other intellectual abilities serious enough to interfere with daily life. There is no cure for Alzheimer’s, however, treating symptoms and getting the right services and support can make life better for those with Alzheimer’s.

Warning Signs

1. Memory loss. Forgetting recently learned information is one of the most common early signs of dementia. A person begins to forget more often and is unable to recall the information later. Occasionally forgetting names or appointments is normal.

2. Difficulty performing familiar tasks. People with dementia often find it hard to plan or complete everyday tasks. Individuals may lose track of the steps involved in preparing a meal, making a phone call or playing a game. Occasionally forgetting why you came into a room or what you were going to say is normal.

3. Problems with language. People with Alzheimer’s disease often forget simple words or substitute unusual words, making their speech or writing hard to understand. For example, a person may be unable to find his/her toothbrush and ask for “that thing for my mouth.” Sometimes having trouble finding the right word to say is normal.

4. Disorientation with time and place. People with Alzheimer’s disease can get lost in their own neighborhood, forget where they are or not remember how they got there and not know how to get back home. Forgetting the day of the week or where you were going is normal.

5. Poor or decreased judgment. Those with Alzheimer’s may dress inappropriately and wear several layers of clothes on a warm day or very little clothing in the cold. They may show poor judgment, like giving away large sums of money to telemarketers. Making a questionable or debatable decision from time to time is normal.

6. Problems with abstract thinking. Someone with Alzheimer’s disease may have unusual difficulty performing complex mental tasks, like forgetting what numbers are for and how they should be used. Finding it challenging to balance a checkbook is normal.

7. Misplacing things. A person with Alzheimer’s disease may put things in unusual places, e.g. putting an iron in the freezer or a wristwatch in the sugar bowl. Temporarily misplacing keys or a wallet is normal.

8. Changes in mood or behavior. Someone with Alzheimer’s disease may show rapid mood swings – from being calm to crying or getting angry – for no apparent reason. Occasionally feeling sad or moody is normal.

9. Changes in personality. The personalities of people with dementia can change dramatically. They may become extremely confused, suspicious, fearful or dependent on a family member. It is normal for a person’s personality to change somewhat as they age.

10. Loss of initiative. A person with Alzheimer’s disease may become very passive, sit in front of the TV for hours, sleep more than usual or not want to do usual activities. Sometimes feeling weary of work or social obligations is normal.

The difference between Alzheimer’s and normal age-related memory changes

Someone with Alzheimer’s disease symptoms:
• Forgets entire experiences
• Rarely remembers later
• Is gradually unable to follow
• Is gradually unable to use notes as reminders
• Is gradually unable to care for self

Someone with normal age-related memory changes:
• Forgets part of an experience
• Often remembers later
• Is usually able to follow written/spoken directions
• Is usually able to use notes as reminders
• Is usually able to care for self

See a physician if you recognize any of the warning signs in a family member. There are other conditions, some that are treatable, that could be causing symptoms. Finding out if someone has Alzheimer’s is an important step to getting appropriate treatment, care and support services.

Every 68 seconds, another American develops Alzheimer’s disease. In 2050, an American will develop the disease every 33 seconds.

An early diagnosis of Alzheimer’s allows a person to:

• Benefit from treatments that may improve symptoms and help maintain a level of independence and quality of life longer
• Have more time to plan for the future
• Increase chances of participating in clinical trials that lead to new treatments
• Participate in decisions about care, transportation, living options, financial and legal matters
• Develop a relationship with doctors and care partners
• Benefit from care and support services, making it easier for them and their family to manage the disease

Risk Factors

While scientists know Alzheimer’s disease involves progressive brain cell failure, they have not yet identified any single reason why cells fail. However, they have identified certain risk factors that increase the likelihood of developing Alzheimer’s.

Risk factors that you cannot change

Age: Most individuals with Alzheimer’s are 65 years old or older. The likelihood of developing Alzheimer’s doubles about every five years after age 65. After age 85, the risk reaches nearly 50 percent. Aging can affect your memory by changing the way you store information and by making it harder to recall stored information.

Family history: Those who have a parent, brother or sister, or child with Alzheimer’s are more likely to develop Alzheimer’s. The risk increases if more than one family member has the illness.

Genetics (heredity): There are two categories of genes that can play a role in determining whether or not a person develops a disease. Alzheimer’s genes have been found in both categories:

Risk genes increase the likelihood of developing a disease, but do not guarantee it will happen. Scientists have so far identified several Alzheimer's risk genes. Those who inherit a copy of some form of the risk genes from one parent have an increased risk of developing Alzheimer’s. Those who inherit risk genes from both parents have an even higher risk, but not a certainty.
Deterministic genes directly cause a disease, guaranteeing that anyone who inherits them will develop the disorder. When Alzheimer’s disease is caused by deterministic genes, many family members in multiple generations are affected. True familial Alzheimer’s accounts for less than 5 percent of cases.

Risk factors you may be able to influence

Head injury: There appears to be a strong link between a serious head injury and a future risk of Alzheimer’s. Protect your head by always fastening your seat belt, wearing a helmet when participating in sports and making sure your home is safe from trips and falls.

Heart-head connection: The risk of developing Alzheimer’s appears to be increased by many conditions that damage the heart or blood vessels, such as high blood pressure, heart disease, stroke, diabetes and high cholesterol. Take care of yourself, know your personal health status and treat health problems that arise.

Age healthfully: Studies suggest that strategies for overall healthy aging can help keep the brain healthy and may even offer some protection against developing Alzheimer’s or related diseases. Keep your weight within recommended guidelines; avoid smoking, tobacco smoke and excess alcohol; stay socially active and exercise regularly. Make sure your physician is aware of any exercise plan you follow.

Mental stimulation: Keep your brain active by doing activities such as puzzles, reading, gardening, playing games, writing, learning a new language, enjoying a hobby or taking a class.

Some change in memory is normal as we age, but the warning signs of Alzheimer’s disease are more than simple lapses in memory. There is no clear-cut line between normal changes and warning signs. Consult a physician if you notice that a person’s level of function seems to be changing. A physician can help determine the cause of memory problems and provide resources to patients and their families so that they receive information, care and support as early as possible.